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Letters   |    
The “Brother’s Arm:” Alien Hand Syndrome After Right Posterior Parietal Lesion
Hannah Shereef, M.D.; Andrea E. Cavanna, M.D., Ph.D.
The Journal of Neuropsychiatry and Clinical Neurosciences 2013;25:E02-E02. doi:10.1176/appi.neuropsych.12080193
View Author and Article Information

The Michael Trimble Neuropsychiatry Research Group
Dept. of Neuropsychiatry
University of Birmingham and BSMHFT
Birmingham, UK
Sobell Department of Motor Neuroscience and Movement Disorders
Institute of Neurology, UCL
London, UK

Correspondence: Prof Andrea Eugenio Cavanna, M.D., Ph.D.; e-mail: A.Cavanna@ion.ucl.ac.uk

Copyright © 2013 American Psychiatric Association

Extract

To the Editor: We report the case of an 82-year-old woman who presented to the hospital with the acute onset of “FAST” (face, arms, speech) symptoms, including left-sided facial weakness, left-sided hemiparesis, and dysarthria. On examination, the patient was also found to have left homonymous hemianopia and left-sided hemi-neglect, with an NIHSS score of 17/32 and a GCS of 13/15. Head CT scan confirmed the diagnosis of ischemic infarct involving the right middle cerebral artery and resulting in a posterior parietal lesion. The patient underwent alteplase thrombolysis without success, despite some initial signs of functional recovery in the 3 days after the stroke. About 6 weeks later, the patient started complaining that she believed her left arm was not her own, but instead belonged to her brother, who had been present with her when she had the stroke. She said that her “brother’s arm” did not do what she wanted and that this was causing her significant distress. These symptoms spontaneously resolved within 3 weeks.

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References

Scepkowski  LA;  Cronin-Golomb  A:  The alien hand: cases, categorizations, and anatomical correlates.  Behav Cogn Neurosci Rev 2003; 2:261–277
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Kessler  J;  Hathout  G:  Dominant posterior-variant alien hand syndrome after acute left parietal infarction.  Clin Neurol Neurosurg 2009; 111:633–635
[CrossRef] | [PubMed]
 
Kloesel  B;  Czarnecki  K;  Muir  JJ  et al:  Sequelae of a left-sided parietal stroke: posterior alien hand syndrome.  Neurocase 2010; 16:488–493
[CrossRef] | [PubMed]
 
Martí-Fàbregas  J;  Kulisevsky  J;  Baró  E  et al:  Alien hand sign after a right parietal infarction.  Cerebrovasc Dis 2000; 10:70–72
[CrossRef] | [PubMed]
 
Sumner  P;  Husain  M:  At the edge of consciousness: automatic motor activation and voluntary control.  Neuroscientist 2008; 14:474–486
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